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Mao A, Van IK, Cheong PL, Tam HL. "This is part of the body" - Student nurses' de-sexualisation of intimate care for patients. NURSE EDUCATION TODAY 2024; 139:106209. [PMID: 38663054 DOI: 10.1016/j.nedt.2024.106209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/25/2024] [Accepted: 04/07/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Effective intimate care can significantly impact the clinical outcomes of patients. However, conducting intimate care, which involves exposing and touching sexually sensitive areas of the body, presents challenges and anxieties for student nurses, particularly when providing care for patients of the opposite sex. OBJECTIVES This study aims to identify the challenges and struggles encountered by student nurses when providing intimate care for patients of the opposite sex, as well as to explore the coping strategies employed by the students. DESIGN A constructivist grounded theory research approach. SETTINGS The study was conducted in Macau, a Special Administrative Region of China. PARTICIPANTS Twenty-six student nurses across various stages of their education, and three clinical mentors. METHODS Purposive and theoretical sampling techniques were utilized to recruit participants. Semi-structured interviews were conducted. The data analysis was in line with the principles of constructivist grounded theory research. RESULTS A two-stage adaptation model was established, demonstrating a dynamic pathway of student nurses toward intimate care. The first stage 'gendered confinement in intimate care' was characterized by student nurses' negative feelings and lack of nurse-patient interactions; the second stage 'emancipation to gendered confinement' was characterized by the development of constructive therapeutic nurse-patient relationships. The successful transfer was achieved through students' reconstructing the meaning of intimate care and nursing profession in three interplayed types: objectification of patients' body, moral authority of nursing care, and legitimisation of nursing profession. While the transfer process involved the students' intentional efforts to de-sexualize intimate care, clinical mentors facilitated the process. CONCLUSION Student nurses' adaption to intimate care is a dynamic process which enhances the construction of the nursing professional identity. Support from nursing educators can facilitate student nurses' coping with intimate care-related challenges.
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Affiliation(s)
- Aimei Mao
- Kiang Wu Nursing College of Macau, Avenida do Hospital das Ilhas no. 447, Coloane, RAEM, Macau.
| | - Iat-Kio Van
- Kiang Wu Nursing College of Macau, Avenida do Hospital das Ilhas no. 447, Coloane, RAEM, Macau
| | - Pak-Leng Cheong
- Kiang Wu Nursing College of Macau, Avenida do Hospital das Ilhas no. 447, Coloane, RAEM, Macau
| | - Hon-Lon Tam
- Kiang Wu Nursing College of Macau, Avenida do Hospital das Ilhas no. 447, Coloane, RAEM, Macau; The Nethersole School of Nursing, Chinese University of Hong Kong, Esther Lee Building, N.T., Hong Kong
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Skyvell Nilsson M, Gadolin C, Larsman P, Pousette A, Törner M. The role of perceived organizational support for nurses' ability to handle and resolve ethical value conflicts: A mixed methods study. J Adv Nurs 2024; 80:765-776. [PMID: 37775477 DOI: 10.1111/jan.15889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 08/17/2023] [Accepted: 09/17/2023] [Indexed: 10/01/2023]
Abstract
AIM To explore if and how nurses' perceived organizational support affects their ability to handle and resolve ethical value conflicts. DESIGN A mixed methods design with a longitudinal questionnaire survey and focus group interviews. METHODS A questionnaire survey in six hospitals in two Swedish regions provided data from 711 nurses responding twice (November-January 2019/2020 and November-January 2020/2021). A cross-lagged path model tested the mutual prospective influence between the organizational climate of perceived organizational support, frequency of ethical value conflicts, and resulting moral distress. Four focus group interviews were conducted with 21 strategically selected nurses (April-October 2021). Qualitative data collection and analysis were inspired by Grounded Theory. RESULTS A climate of perceived organizational support was empowering, contributing to role security. It prospectively decreased the frequency of ethical value conflicts but not the moral distress when conflicts did occur. CONCLUSION It is important to facilitate the development of perceived organizational support among nurses, but also to reduce the occurrence of ethical value conflicts that the nurses cannot resolve. IMPLICATIONS FOR THE PROFESSION By ensuring a shared care ideology, good inter-professional relations within the entire care organization, providing clear and supportive organizational structures, and utilizing competence adequately, healthcare managers can facilitate and support the development of perceived organizational support among nurses. Nurses who are empowered by perceived organizational support are stimulated by and take pride in their work and experience the work as meaningful and joyful. IMPACT The study addressed the question of whether healthcare organizations could support nurses to resolving ethical value conflicts, and thus reduce moral distress. Perceived organizational support is related to factors such as ideological caring alignment and supportive organizational preconditions. This study contributes specific knowledge about how healthcare organizations can empower nurses to effectively resolve ethical value conflicts and thereby reduce their moral distress. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
| | - Christian Gadolin
- School of Business, Economics and IT, University West, Trollhättan, Sweden
| | - Pernilla Larsman
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Anders Pousette
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marianne Törner
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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3
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Al-Chami MH, Gifford W, Coburn V. A visionary platform for decolonization: The Red Deal. Nurs Philos 2024; 25:e12471. [PMID: 38014606 DOI: 10.1111/nup.12471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 08/09/2023] [Accepted: 11/11/2023] [Indexed: 11/29/2023]
Abstract
In this study, we discuss the colonial project as an eliminatory structure of indigenous ways of knowing and doing that is built into Canadian social and health institutions. We elaborate on the role nursing plays in maintaining systemic racism, marginalization and discrimination of Indigenous Peoples. Based on historical practices and present-day circumstances, we argue that changing language in research and school curriculums turns decolonization into what Tuck and Yang call a 'metaphor'. Rather, we propose decolonization as a political project where nurses acknowledge their involvement in colonial harms and disrupt the assumptions that continue to shape how nurses interact with Indigenous people, including knowledge systems that perpetuate colonial interests and privilege. Decolonization requires nurses to understand the colonial practices that led to dispossession of land, erasure of knowledge, culture and identity, while upholding indigenous ways of knowing and doing in health, healing and living. As a political manifesto that liberates indigenous life from oppressive structures of colonialism and capitalism, The Red Deal is presented as a visionary platform for decolonization. The aim of this study is to articulate three dimensions of caretaking within The Red Deal as a framework to decolonize nursing knowledge development and practice. Based on the philosophical dimension embedded in The Red Deal that revoke norms and knowledge assumptions of capitalism that destroy indigenous ways of knowing and doing, we underscore an approach toward decolonizing nursing. Our approach rejects the apolitical nature of nursing as well as the unilateral western scientific knowledge approach to knowledge development and recognition. A critical emancipatory approach that addresses the socio-political and historical context of health care, recognizes dispossession of land and adopts a 'multilogical' vision of knowledge that gives space for representation and voice is needed for true decolonization of nursing.
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Affiliation(s)
- Mohamad H Al-Chami
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Wendy Gifford
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Loyer DaSilva Research Chair in Community & Public Health Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Centre for Research on Health and Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Veldon Coburn
- Indigenous Relations Initiative, School of Continuous Studies, McGill University, Montreal, Quebec, Canada
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Ferreira Umpiérrez A, Pérez M, Valli C, Gómez Garbero L, Olivera C, Moreno Dias B, De Bortoli Cassiani SH. [Health policy dialogue to strengthen nursing in UruguayDiálogo político-sanitário para o fortalecimento da enfermagem no Uruguai]. Rev Panam Salud Publica 2023; 47:e147. [PMID: 37881799 PMCID: PMC10597393 DOI: 10.26633/rpsp.2023.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/25/2023] [Indexed: 10/27/2023] Open
Abstract
This article presents the experience of the health policy dialogue on nursing held in Uruguay in 2021, based on the theory of change. Four working groups were held, with the participation of 725 people. The points discussed included: the shortage of registered nurses to implement programs and cover functions at all levels of health care; the poor visibility of the healthcare impact of the activities carried out; insufficient financial resources for undergraduate and postgraduate training; and poor integration of nurses in management teams and policy decision-making spaces in the country. Participants expressed the need to implement the national nursing development plan so that the country can: reduce the shortage of professionals; invest in job creation to meet the demand for professional care; improve staffing of services at all levels of care; improve working conditions; create new spaces for nurses by expanding their role through postgraduate training, while continuously improving the quality of training. Participants emphasized the need to increase intersectoral coordination in the areas of governance, regulation, and management, and to step up efforts to increase investment in health professionals in Uruguay.
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Affiliation(s)
| | - Mercedes Pérez
- Universidad de la RepúblicaMontevideoUruguayUniversidad de la República, Montevideo, Uruguay.
| | - Carlos Valli
- Ministerio de Salud PúblicaUruguayMinisterio de Salud Pública, Uruguay.
| | - Lucía Gómez Garbero
- Universidad Católica del UruguayMontevideoUruguayUniversidad Católica del Uruguay, Montevideo, Uruguay.
| | - Camila Olivera
- Universidad de la RepúblicaMontevideoUruguayUniversidad de la República, Montevideo, Uruguay.
| | - Bruna Moreno Dias
- Organización Panamericana de la Salud/Organización Mundial de la SaludWashington, D.C.Estados Unidos de AméricaOrganización Panamericana de la Salud/Organización Mundial de la Salud, Washington, D.C., Estados Unidos de América
| | - Silvia Helena De Bortoli Cassiani
- Organización Panamericana de la Salud/Organización Mundial de la SaludWashington, D.C.Estados Unidos de AméricaOrganización Panamericana de la Salud/Organización Mundial de la Salud, Washington, D.C., Estados Unidos de América
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5
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López‐Deflory C, Perron A, Miró‐Bonet M. An integrative literature review and critical reflection on nurses' agency. Nurs Inq 2023; 30:e12515. [PMID: 35971209 PMCID: PMC10078309 DOI: 10.1111/nin.12515] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 01/25/2023]
Abstract
The idea of agency has long been used in the nursing literature in the study of nurses' roles regarding the patients they take care of, but it has not often been used to study its relationship with nurses themselves and their status in the healthcare system. The purpose of this article is to analyze how the idea of agency is used in nursing research to better understand how we might advance our thinking around nurses' agency to shape nursing and healthcare with an emancipatory intent. Based on the results of a literature review focused on the study of conceptions, treatments, and applications of the concept of agency in nursing, we present a critical discussion to reflect on the need to consistently define the idea of nurses' agency, to guide research concerned with this topic in theoretical frameworks with emancipatory and social change tenets, and to make a call to develop the idea of agency as a central one to rework nurses' relationship with themselves. The idea of agency provides a valuable analytical framework for the study of a wide range of issues around nurses' status in healthcare organizations and in the healthcare system while offering a means for nurses' emancipation.
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Affiliation(s)
- Camelia López‐Deflory
- Department of Nursing and PhysiotherapyUniversity of the Balearic IslandsPalmaBalearic IslandsSpain
- Care, Chronicity and Health Evidences Research GroupHealth Research Institute of the Balearic Islands (IdISBa)PalmaBalearic IslandsSpain
| | - Amélie Perron
- School of Nursing, Faculty of Health SciencesUniversity of OttawaOttawaOntarioCanada
| | - Margalida Miró‐Bonet
- Department of Nursing and PhysiotherapyUniversity of the Balearic IslandsPalmaBalearic IslandsSpain
- Care, Chronicity and Health Evidences Research GroupHealth Research Institute of the Balearic Islands (IdISBa)PalmaBalearic IslandsSpain
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6
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Purvis JK. Applying a Foucauldian lens to the Canadian code of ethics for registered nurses as a discursive mechanism for nurses professional identity. Nurs Inq 2022; 30:e12536. [PMID: 36260285 DOI: 10.1111/nin.12536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 11/28/2022]
Abstract
This study examines the Canadian Code of Ethics for Registered Nurses as a discursive mechanism for shaping nurses' professional identity using a Foucauldian lens. Nurses are considered essential in healthcare, yet the nursing profession has struggled to be recognized for its discipline-specific knowledge and expertise and, as such, has remained the subject of and subject to the dominant discourses within healthcare and society generally. Developing a professional identity in nursing begins after the necessary education and training are achieved and embodies the profession's history, values, code of ethics, and expectations of the profession that distinguish it from other professions. Since nurses' professional identity is shaped through discourse, it raises the question of whether there are spaces to reconceptualize nurses' subject position within health care. Since professional identity is considered the embodiment of knowledge and practice, the code of ethics bears examination both for its effect on nurses' professional identity and as a potential site from which to challenge hegemonic assumptions. This article discusses the concept of professional identity in nursing and its development through the discursive formations in the code of ethics. The sources of power/knowledge are examined as both mechanisms of control and as spaces for change.
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Affiliation(s)
- Janet K Purvis
- Rankin School of Nursing, St Francis Xavier University, Antigonish, Canada
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7
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López‐Deflory C, Perron A, Miró‐Bonet M. Social acceleration, alienation, and resonance: Hartmut Rosa's writings applied to nursing. Nurs Inq 2022; 30:e12528. [PMID: 36115014 DOI: 10.1111/nin.12528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/27/2022]
Abstract
This article aims to present the life and work of German thinker Hartmut Rosa as a philosopher of interest for nursing. Although his theoretical framework remains fairly unknown in the nursing domain, its main key concepts open up a philosophical and sociological approach that can contribute to the understanding of a wide range of study phenomena related to nurses, nursing, and healthcare. The concepts of social acceleration, alienation, and resonance are useful to explore healthcare organizations' performance by bringing the time dimension of modernity to the center; to grasp nurses' experiences of caring for patients; and to understand nurses as agents endowed with the capacity to deploy their political agency to create alternative forms of relationship to themselves, to others, and the world, challenging the institutional order of healthcare organizations when it fails to resonate with their professional ethos. In this article, we propose Hartmut Rosa's theoretical framework as a new and inspiring phenomenological and critical lens that should be further explored to advance knowledge concerning phenomena that are found at the crossroads of the nursing domain and other fields of knowledge.
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Affiliation(s)
- Camelia López‐Deflory
- Department of Nursing and Physiotherapy University of the Balearic Islands Palma Balearic Islands Spain
- Care, Chronicity and Health Evidences Research Group Health Research Institute of the Balearic Islands (IdISBa) Palma Balearic Islands Spain
| | - Amélie Perron
- School of Nursing, Faculty of Health Sciences University of Ottawa Ottawa Ontario Canada
| | - Margalida Miró‐Bonet
- Department of Nursing and Physiotherapy University of the Balearic Islands Palma Balearic Islands Spain
- Care, Chronicity and Health Evidences Research Group Health Research Institute of the Balearic Islands (IdISBa) Palma Balearic Islands Spain
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8
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Stress Levels and Coping Strategies Among Undergraduate Nursing Students in Greece During Economic Recession. Nurse Educ Pract 2022; 60:103299. [DOI: 10.1016/j.nepr.2022.103299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 11/18/2022]
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9
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Abate HK, Abate AT, Tezera ZB, Beshah DT, Agegnehu CD, Getnet MA, Yazew BG, Alemu MT, Mekonenn CK, Kassahun CW. The Magnitude of Perceived Professionalism and Its Associated Factors Among Nurses in Public Referral Hospitals of West Amhara, Ethiopia. NURSING: RESEARCH AND REVIEWS 2021. [DOI: 10.2147/nrr.s328749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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10
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Llop-Gironés A, Vračar A, Llop-Gironés G, Benach J, Angeli-Silva L, Jaimez L, Thapa P, Bhatta R, Mahindrakar S, Bontempo Scavo S, Nar Devi S, Barria S, Marcos Alonso S, Julià M. Employment and working conditions of nurses: where and how health inequalities have increased during the COVID-19 pandemic? HUMAN RESOURCES FOR HEALTH 2021; 19:112. [PMID: 34530844 PMCID: PMC8444178 DOI: 10.1186/s12960-021-00651-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/30/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Nurses and midwives play a critical role in the provision of care and the optimization of health services resources worldwide, which is particularly relevant during the current COVID-19 pandemic. However, they can only provide quality services if their work environment provides adequate conditions to support them. Today the employment and working conditions of many nurses worldwide are precarious, and the current pandemic has prompted more visibility to the vulnerability to health-damaging factors of nurses' globally. This desk review explores how employment relations, and employment and working conditions may be negatively affecting the health of nurses in countries such as Brazil, Croatia, India, Ireland, Italy, México, Nepal, Spain, and the United Kingdom. MAIN BODY Nurses' health is influenced by the broader social, economic, and political system and the redistribution of power relations that creates new policies regarding the labour market and the welfare state. The vulnerability faced by nurses is heightened by gender inequalities, in addition to social class, ethnicity/race (and caste), age and migrant status, that are inequality axes that explain why nurses' workers, and often their families, are exposed to multiple risks and/or poorer health. Before the COVID-19 pandemic, informalization of nurses' employment and working conditions were unfair and harmed their health. During COVID-19 pandemic, there is evidence that the employment and working conditions of nurses are associated to poor physical and mental health. CONCLUSION The protection of nurses' health is paramount. International and national enforceable standards are needed, along with economic and health policies designed to substantially improve employment and working conditions for nurses and work-life balance. More knowledge is needed to understand the pathways and mechanisms on how precariousness might affect nurses' health and monitor the progress towards nurses' health equity.
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Affiliation(s)
- Alba Llop-Gironés
- Research Group on Health Inequalities, Environment, and Employment Conditions (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Escola Superior d’Infermeria del Mar (ESIMar), Barcelona, Spain
- Social Determinants and Health Education Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Ana Vračar
- Organization for Workers’ Initiative and Democratization, Zagreb, Croatia
| | | | - Joan Benach
- Research Group on Health Inequalities, Environment, and Employment Conditions (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- The Johns Hopkins - UPF Public Policy Center (JHU-UPF PPC), Barcelona, Spain
- Transdisciplinary Research Group On Socioecological Transitions (GinTrans2), Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | - Mireia Julià
- Research Group on Health Inequalities, Environment, and Employment Conditions (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Escola Superior d’Infermeria del Mar (ESIMar), Barcelona, Spain
- Social Determinants and Health Education Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
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McCready G, Lajeunesse-Mousseau MÈ, Lapalme J, Harrisson S. Travail de care des travailleuses de la santé en situation de pandémie de COVID-19 : quel engagement de la part des autorités gouvernementales? Glob Health Promot 2021; 29:110-118. [PMID: 34525865 PMCID: PMC9003780 DOI: 10.1177/17579759211042764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
La COVID-19 a pressé les gouvernements à intervenir à l'aide de données partielles sur l'efficacité des moyens. Les femmes sont particulièrement touchées car elles sont plus nombreuses à s'occuper des autres. Cette étude a pour but de comprendre l'influence des décisions politiques sur les conditions de vie et de travail des travailleuses de la santé. Une analyse des interventions gouvernementales de santé publique du Québec et des revendications des travailleuses de la santé retrouvées dans les documents journalistiques et les communiqués de presse officiels du gouvernement (13 avril au 1er juillet 2020) a été effectuée. Les résultats démontrent le manque de reconnaissance des autorités face à certains types de care, ainsi qu'une inadéquation dans les moyens de prise en charge pour prendre soin de la population. Le peu de reconnaissance des conditions de vie et de travail lors de décisions politiques engendre une répartition inéquitable des fardeaux associés à la pandémie.
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Affiliation(s)
- Geneviève McCready
- Professeure régulière, Département des sciences de la santé, Module des sciences infirmières, Université du Québec à Rimouski, Rimouski, Québec, Canada
| | | | - Josée Lapalme
- Candidate au doctorat, Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal (ESPUM) et Centre de recherche en santé publique (CReSP), Montréal, Québec, Canada
| | - Sandra Harrisson
- Professeure adjointe, École des sciences infirmières, Université d'Ottawa, Ottawa, Ontario, Canada
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Gunn V, Somani R, Muntaner C. Health care workers and migrant health: Pre- and post-COVID-19 considerations for reviewing and expanding the research agenda. J Migr Health 2021; 4:100048. [PMID: 34405193 PMCID: PMC8352207 DOI: 10.1016/j.jmh.2021.100048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/11/2021] [Accepted: 05/20/2021] [Indexed: 11/24/2022] Open
Abstract
The main purpose of this article is to review several ways in which health care workers could either impact migrant health or be directly impacted by migration and, based on this, suggest the expansion of the current research agenda on migration and health to address a range of topics that are currently either neglected, insufficiently researched, or researched from different perspectives. To ground this suggestion and emphasize the complexity and significance of migrant health research, we start by briefly reviewing several migration-related notions including the process of migration and its key facilitators and benefits; existing barriers to the provision of migrant health care; and the intricate links between health systems, health professionals, and migrant health. The three areas of research examined in this article address (i) the specific role of health workers in providing care to migrants and refugees and their capacity to do so, (ii) the health problems experienced by health workers who become migrants or refugees, and (iii) the precarious employment conditions experienced by both migrant and non-migrant health care workers. After summarizing the current available evidence on these topics, we discuss key information gaps and strategies to address them, while also incorporating several relevant COVID-19 pandemic considerations and research implications. Expanding the focus of research studies on migration and health could not only enhance the results of current strategies by supplying additional information to support their implementation but also spearhead the development of new solutions to the migrant health problem.
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Affiliation(s)
- Virginia Gunn
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada
- Karolinska Institute, Sweden
| | - Rozina Somani
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada
- Collaborative Specialization in Global Health, Dalla Lana School of Public Health, University of Toronto, Canada
| | - Carles Muntaner
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Canada
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Hoff JL, Kuiper M. The governmentality of nursing professionalization in advanced liberal societies. JOURNAL OF PROFESSIONS AND ORGANIZATION 2021. [DOI: 10.1093/jpo/joaa027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
In Western countries, the occupational discipline of nursing is undergoing processes of professionalization. Although professionalization offers an appealing perspective on occupational advancement, it is an ambiguous process, especially in the context of ongoing reforms of advanced liberal states. More specifically, there is a confusing relationship between the professionalization of nursing and the state. This relation is underexamined in theories of nursing professionalization. Instead of seeing the state and professions as two distinct spheres, this article highlights their interconnectedness. It argues that nursing professionalization can be understood as a strategy of advanced liberal governmentality. Through an empirical analysis of the professionalization of Dutch nursing from a Foucauldian perspective, it shows how the appeal to ‘professionalism’ functions as a disciplinary mechanism that produces forms of advanced liberal ‘(bio)power’. This generates academic and practical questions, since nurses—the largest group of healthcare professionals—have distinctive relations with their patients, who regard them as ‘independent’ and ‘caring experts’. Furthermore, it sheds light on the academic debate about the reconfiguration of professionalism by showing how certain ‘professional’ reconfigurations are not only unavoidable but unavoidably (bio)political as well.
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Affiliation(s)
- Jan-Luuk Hoff
- Utrecht University School of Governance, Utrecht University, 3511 ZC Utrecht, the Netherlands
| | - Marlot Kuiper
- Utrecht University School of Governance, Utrecht University, 3511 ZC Utrecht, the Netherlands
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14
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Bell B. Towards abandoning the master's tools: The politics of a universal nursing identity. Nurs Inq 2020; 28:e12395. [PMID: 33332732 DOI: 10.1111/nin.12395] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 11/13/2020] [Accepted: 11/20/2020] [Indexed: 11/28/2022]
Abstract
Healthcare environments continue to prove discriminatory and marginalizing towards patients and healthcare workers themselves, which contributes to inequitable health outcomes across lines of socially constructed difference. This content and discourse analysis of nursing identity scholarship asks whether there is a connection between nursing identity and oppressive behaviour by examining the construction of nursing identity and the foundational discourses, sometimes in absentia, that support such a construction. Bourdieu's concepts of social fields and Audre Lorde's concept of the master's house are applied as a framework towards understanding the constructs of power and status in healthcare. The analysis identifies a gap in nursing identity literature where social constructs of difference are not considered. In the reviewed literature, nursing identity has been co-opted by the professionalization project in effort to stabilize a conceptualization of nursing's contribution to healthcare towards gaining professional and societal status. This leads to a monolithic, apolitical representation of nursing identity that erases difference, denies historical influence, universalizes nursing work and further marginalizes marginalized identities. The oppressive and hegemonic nature of a universal nursing identity may contribute to a lack of disciplinary reflexivity about the ongoing influences of foundational discursive constructs of gender, epistemology, power and professional status.
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Affiliation(s)
- Blythe Bell
- Leadership Studies, University of Victoria, Victoria, BC, Canada
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Oates J, Topping A, Ezhova I, Wadey E, Marie Rafferty A. An integrative review of nursing staff experiences in high secure forensic mental health settings: Implications for recruitment and retention strategies. J Adv Nurs 2020; 76:2897-2908. [PMID: 32951214 DOI: 10.1111/jan.14521] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/08/2020] [Accepted: 07/23/2020] [Indexed: 12/12/2022]
Abstract
AIMS To identify the experiences of nursing in high secure forensic mental health settings that may affect staff recruitment and retention. BACKGROUND Recruitment and retention of Registered Nurses is a vital international concern in the field of mental health. The high secure forensic setting presents unique challenges for the nurse. Studies of nurse's experiences in this setting have not previously been reviewed in the context of workforce sustainability pressures. DESIGN An integrative review (Whittemore and Knapfl, 2005). DATA SOURCES A systematic search of data sources: MEDLINE (PubMed), PsycINFO, EMBASE, CINAHL, International Bibliography of the Social Sciences, Applied Social Sciences Index and Abstracts (ASSIA), Social Services Abstracts, ProQuest Social Sciences Premium collection (IBSS, PAIS, and Sociological Abstracts), and Web of Science from inception to December 2019. REVIEW METHODS Data extraction, quality appraisal, and convergent qualitative synthesis. RESULTS Fifteen papers were selected for inclusion in the review, describing 13 studies. Six studies were quantitative, all cross-sectional surveys. There were seven qualitative studies, using a variety of methodologies. Four themes were identified: engagement with the patient group, the ward social environment, impact on the nurse, and implications for practice. CONCLUSION When policymakers address workforce shortages in high secure forensic nursing they must take account of the unique features of the setting and patient group. Nurses must be adequately prepared and supported to function in an ethically and emotionally challenging environment. IMPACT This study identified factors affecting workforce pressures in the speciality of forensic mental health nursing. Findings are of interest to national nursing policymakers and workforce leads in mental health service provider organizations, seeking to promote forensic nursing as a career option and retain nursing staff.
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Affiliation(s)
- Jennifer Oates
- Florence Nightingale Faculty of Nursing, King's College London, London, UK
| | - Alice Topping
- Florence Nightingale Faculty of Nursing, King's College London, London, UK.,West London NHS Trust, London, UK
| | - Ivanka Ezhova
- Florence Nightingale Faculty of Nursing, King's College London, London, UK
| | - Emma Wadey
- NHS England and NHS Improvement, London, UK
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Bayliss‐Pratt L, Daley M, Bhattacharya‐Craven A. Nursing Now 2020: the Nightingale Challenge. Int Nurs Rev 2020; 67:7-10. [DOI: 10.1111/inr.12579] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gunn V, Muntaner C, Ng E, Villeneuve M, Gea-Sanchez M, Chung H. Gender equality policies, nursing professionalization, and the nursing workforce: A cross-sectional, time-series analysis of 22 countries, 2000-2015. Int J Nurs Stud 2019; 99:103388. [PMID: 31493758 DOI: 10.1016/j.ijnurstu.2019.103388] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 05/18/2019] [Accepted: 07/26/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Nursing professionalization has substantial benefits for patients, health care systems, and the nursing workforce. Currently, however, there is limited understanding of the macro-level factors, such as policies and other country-level determinants, influencing both the professionalization process and the supply of nursing human resources. OBJECTIVES Given the significance of gender to the development of nursing, a majority-female occupation, the purpose of this analysis was to investigate the relationship between gender regimes and gender equality policies, as macro-level determinants, and nursing professionalization indicators, in this case the regulated nurse and nurse graduate ratios. DESIGN This cross-sectional, time-series analysis covered 16 years, from 2000 to 2015, and included 22 high-income countries, members of the Organisation for Economic Co-operation and Development. We divided countries into three clusters, using the gender policy model developed by Korpi, as proxy for gender regimes. The countries were grouped as follows: (a) Traditional family - Austria, Belgium, France, Germany, Greece, Italy, Netherlands, Portugal, and Spain; (b) Market-oriented - Australia, Canada, Ireland, Japan, New Zealand, South Korea, Switzerland, United Kingdom, and the United States; and (c) Earner-carer - Denmark, Finland, Norway, and Sweden. METHODS We used fixed-effects linear regression models and ran Prais-Winsten regressions with panel-corrected standard errors, including a first-order autocorrelation correction to examine the effect of gender equality policies on nursing professionalization indicators. Given the existence of missing observations, we devised and implemented a multiple imputation strategy, with the help of the Amelia II program. We gathered our data from open access secondary sources. RESULTS Both the regulated nurse and nurse graduate ratios had averages that differed across gender regimes, being the highest in Earner-carer regimes and the lowest in Traditional family ones. In addition, we identified a number of indicators of gender equality policy in education, the labour market, and politics that are predictive of the regulated nurse and nurse graduate ratios. CONCLUSION This study's findings could add to existing upstream advocacy efforts to strengthen nursing and the nursing workforce through healthy public policy. Given that the study consists of an international comparative analysis of nursing, it should be relevant to both national and global nursing communities.
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Affiliation(s)
- Virginia Gunn
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, M5T 1P8, Canada; Dalla Lana School of Public Health, Collaborative Specialization in Global Health, University of Toronto, Ontario, M5T 1P8, Canada.
| | - Carles Muntaner
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, M5T 1P8, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario, M5T 1P8, Canada
| | - Edwin Ng
- School of Social Work, Renison University College, University of Waterloo, Ontario, N2L 3G1, Canada
| | - Michael Villeneuve
- Governance and Strategy, Canadian Nurses Association, Ottawa, K2P 1E2, Canada
| | - Montserrat Gea-Sanchez
- GESEC Group, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Catalunya, ES 25003, Spain; GRECS Group, Biomedical Research Institute of Lleida, Lleida, Spain
| | - Haejoo Chung
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, South Korea; School of Health Policy & Management, College of Health Sciences, Korea University, Seongbuk-gu, Seoul, KR 02841, South Korea
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Gunn V, Muntaner C, Ng E, Villeneuve M, Gea‐Sanchez M, Chung H. The influence of welfare state factors on nursing professionalization and nursing human resources: A time‐series cross‐sectional analysis, 2000–2015. J Adv Nurs 2019; 75:2797-2810. [DOI: 10.1111/jan.14155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/30/2019] [Accepted: 07/03/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Virginia Gunn
- Lawrence S. Bloomberg Faculty of Nursing University of Toronto Toronto ON Canada
- Collaborative Doctoral Program in Global Health, Dalla Lana School of Public Health University of Toronto Toronto ON Canada
| | - Carles Muntaner
- Lawrence S. Bloomberg Faculty of Nursing University of Toronto Toronto ON Canada
- Dalla Lana School of Public Health University of Toronto Toronto ON Canada
| | - Edwin Ng
- School of Social Work Renison University College, University of Waterloo Waterloo ON Canada
| | | | - Montserrat Gea‐Sanchez
- GESEC Group, Faculty of Nursing and Physiotherapy University of Lleida Lleida Spain
- GRECS Group Biomedical Research Institute of Lleida Lleida Spain
| | - Haejoo Chung
- Department of Public Health Sciences, Graduate School Korea University Seoul South Korea
- School of Health Policy & Management College of Health Sciences, Korea University Seoul South Korea
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